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Get Gemini Adventures Desert RATS Pre-participation History & Physical Form

DOB (mm/dd/yyyy): Please circle yes or no to the following. Be sure to discuss any yes answers with your physician: 1. Are you currently taking any prescription or over the counter medications, supplements, or vitamins? Y N 2. Do you have any current injury/illness that may impact your participation in this event? Y N Section 2 (To be completed in conjunction with history, physical exam, and any additional assessment modalities as deemed appropriate by a licensed primary care physi.

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